PA-03-107, entitled "NIH Exploratory/Developmental Research Grant Award", indicates on page 2 that "the R21 mechanism is intended to encourage new exploratory and developmental research projects. ... [An] example could include the unique and innovative use of an existing methodology to explore a new scientific area." This objective perfectly matches the intent of this proposal. We will shift existing prevention methodologies to a new area, namely, from long-term alcohol treatment settings to a brief 4-day alcohol detoxification setting for HIV prevention purposes. Our Stage 1 developmental work will explore the use of brief adaptations of motivational interviewing (BMI) in a new venue (brief alcohol detoxification), with high-risk individuals who traditionally have had limited access to HIV prevention interventions. We will use BMI for HIV/STD prevention with this underserved group of individuals who are not yet likely to be motivated to address the issue of HIV/STD prevention. We will add biological feedback to enhance motivational impact and will explore our novel methods in a culturally diverse setting (45% Alaska Native). During Phase One (Stage 1a developmental phase), we will develop session outlines and intervention manuals through focus groups and key informant interviews. During Phase Two (Stage 1 b exploratory phase), we will test feasibility and utility of the novel application of brief motivational interventions to HIV prevention in culturally diverse clients in brief alcohol detoxification treatment. We will explore three interventions with 25 individuals per condition and with a 3-month follow-up: (a) Risk Assessment Intervention: participants respond to a standard risk assessment protocol, receive standard HIV/STD risk reduction information and referral to community services; (b) Motivational Interviewing Intervention: participants respond to a risk assessment protocol and receive an HIV/STD prevention intervention based on brief adaptations of motivational interviewing, including personalized risk feedback, personalized risk reduction plans, behavioral skills training, and referral to relevant community services; and (c) Motivational Interviewing and Biological Feedback Intervention: participants receive intervention (b) AND pre-test counseling AND provide a biological specimen for STD testing, followed by post-test counseling, STD test feedback, and referral for treatment. All individuals will be assessed after three months. Our exploratory work will produce session outlines and manuals as well as laying the foundation for an RO1 proposal that will use a rigorous experimental design to test the novel strategies developed in the current study.